Review Articles

Overview of Link Between Inflammatory Bowel Disease and Cardiovascular Disease

Nevulis, Matthew G. MD^*; Baker, Colby MD^†; Lebovics, Edward MD^‡; Frishman, William H. MD^§

From the ^*Department of Internal Medicine, University of Virginia, Charlottesville, VA

^†Department of Internal Medicine, Loyola University Medical Center, Maywood, IL

^‡Division of Gastroenterology, Department of Medicine, New York Medical College/Westchester Medical Center, Valhalla, NY

^§Department of Medicine, New York Medical College/Westchester Medical Center, Valhalla, NY.

Disclosure: The authors declare no conflict of interest.

Correspondence: William H. Frishman, MD, Department of Medicine, New York Medical College, 40 Sunshine Cottage Road Valhalla, NY 10595. E-mail: [email protected].

Cardiology in Review 26(6):p 287-293, November/December 2018. | DOI: 10.1097/CRD.0000000000000214

Abstract

Inflammation has been shown to play an increasingly important role in the pathogenesis of atherosclerosis and in precipitating thrombotic events. Inflammatory bowel disease (IBD) is a systemic inflammatory disorder with a wide range of extraintestinal manifestations including a clinically significant increase in the risk of venous thromboembolism compared to matched controls in several studies. The data for the association between IBD and ischemic heart disease are less clear; multiple population-based studies have shown both positive and negative associations between the 2 conditions. While the systemic inflammation should theoretically increase the risk for cardiovascular disease, inflammatory bowel also potentially provides a cardioprotective effect in several ways. Patients with IBD typically enter the healthcare system at an earlier age and experience a lower incidence of obesity, hypercholesterolemia, and hyperlipidemia. Given the complex interplay among the proatherogenic, prothrombogenic, and cardioprotective effects, IBD should be taken into consideration as a nontraditional risk factor for cardiovascular disease in specific subsets of patients.